How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $354.81 | Professional | None | $199.53 | $295.12 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $416.87 | Professional | None | $173.78 | $323.59 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $208.93 Typical High $1,380.38 | Facility | None | $177.83 | $208.93 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $489.78 | Professional | None | $223.87 | $269.15 | $489.78 |
ConnectiCare Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $380.19 | Professional | None | $302.00 | $302.00 | $380.19 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $575.44 | Professional | None | $165.96 | $251.19 | $575.44 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $147.91 Typical High $165.96 | Professional | 52 · Reduced service | $100.00 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $58.88 Typical High $66.07 | Professional | 53 · Discontinued | $39.81 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $223.87 Typical High $245.47 | Professional | 54 · Surgery only | $151.36 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $44.67 Typical High $48.98 | Professional | 55 · Aftercare only | $30.20 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $29.51 Typical High $33.11 | Professional | 56 · Pre-op care only | $19.95 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $208.93 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $141.25 | $208.93 | $229.09 |
Where Connecticut sits
The same service costs 4.9 times more in Oklahoma than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Connecticut· 12th of 51
$316
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.